Blog

Why All The Root Canal Hate?

| 05-18-2018
root canal treatment

A Leading Expert Reflects on Improvements in Root Canal Treatment
 


— Dr. Adham Azim
Guest Author for Hu-Friedy

forceps photoRoot Canal Awareness Week had me thinking about how far the field of endodontics has advanced over the past couple decades, and how far it still has to go — especially in its perception among patients and dental professionals.

The American Association of Endodontists says we are “the superheroes of saving teeth.” I think that’s true.

In a nationwide study of more than 1 million teeth that had received root canal treatment, 97 percent remained functioning eight years later. The study’s authors concluded that endodontic treatment is a predictable procedure that allows patients to retain their teeth.

Yet, I often hear patients and — disappointingly — some of my colleagues in the dental field say that teeth requiring root canal treatment are not worth saving. They claim dental implants would be a better option.

But all the recent research has shown that dental implants can cause long-term complications. It’s better to maintain the tooth for as long as possible before considering dental implants.

The AAE is right to dedicate a week once a year to celebrating the work of endodontists and raise awareness of the tooth-saving value of root canal procedures. Misconceptions and unfounded fear are preventing patients from enjoying healthy, functional teeth for longer.

This Isn’t Your Parents’ Root Canal

The various endodontic procedures are designed to alleviate pain and prevent further infection of the jawbone, as well as maintain tooth function. Proper diagnosis and treatment require:

As in many other fields of dentistry, the last two decades have witnessed a whirlwind of advancement in endodontic tools and techniques. It began with the adoption of rotary instruments and apex locators and continued with the widespread use of dental operating microscopes to achieve high magnification and more predictable results.

Pluggers photoMy own practice and teaching philosophy have been revolutionized by the use of 3D scanning or cone beam computed technology (CBCT). With this technology, practices like mine can evaluate the root canal anatomy and the associated structure in three dimensions. We can now better understand the cause of pathology and accurately determine the best approach to treat our patients.

Whatever field of dentistry you work in, I highly recommend you collaborate with endodontists that use CBCT. They shouldn’t be hard to find. A recent AAE survey found that almost half of endodontists have a CBCT machine in their offices and 80 percent have access to a CBCT machine.

Root Canal Pain Is a Thing of the Past

One of the most persistent myths about root canal procedures is that they’re painful. This hasn’t been the case for decades. Root canals remove the source of pain.

In today’s practice, root canal treatment is virtually pain-free. Thanks to modern instruments and the expert application of anesthesia, patients can expect to not feel any pain or discomfort during their procedure.

Of course, as with any surgical procedure, there can be minor discomfort following treatment. This can be predictably controlled using pain medication, and it will gradually subside within a week or less.

Endodontics and Restoration Go Hand-in-Hand

What is the source of the misconception that root canal procedures are not predictable and endodontically treated teeth may quickly lose their function? Perhaps it’s because of dental professionals failing to restore teeth after treatment adequately.

As I mentioned above, 97 percent of teeth that have undergone a root canal procedure continue to function for at least another eight years. Among those that are extracted, 85 percent have not been permanently restored.

Patients need to be aware that, following root canal treatment, teeth often need a full coverage restoration — a crown — to protect them from further damage. Leaving a tooth unrestored may result in tooth fracture and early loss of the tooth.

The time from, completing the root canal treatment to receiving the crown is also critical. A recent study found that waiting more than two months after root canal treatment without placing a crown can significantly affect the survivability of a tooth.

Finally, it’s worth noting that the best way to treat endodontic problems is to prevent them in the first place. Early screenings can help dentists and endodontists maintain the vitality of the tooth and, perhaps, avoid root canal treatment entirely.

Regular follow-ups after root canal treatment are also necessary to ensure that the tooth is healthy, disease-free, and functioning. These follow-up appointments are very short and free of charge. Encourage your patients to take advantage of such appointments.

Endodontists Rely on Precision Instruments

Root Canal Awareness Week is an annual reminder that endodontics has evolved into an essential dental specialty that prevents suffering and saves teeth. Modern technology is partly to thank for this, as are trained, dedicated professionals using the best instruments available.

Click to Learn more about Hu-Friedy’s extensive line of endodontic instrumentation and Black Line Rubber Dam Clamps.

About the Author

Dr. Adham AzimDr. Adham Azim is the Division Head and Director of the Endodontic Post-Graduate Program at the University at Buffalo (UB) in New York. He maintains a private practice limited to Endodontics, and he is also the Founder and Chief Editor of Endolit.

Dr. Azim is a Diplomate of the American Board of Endodontics. He has lectured in several countries in North and South America, Europe, Asia, Africa and the Middle East. He has been awarded several times for his research work including first prize in the American Association of Endodontics research Award, and first prize in the Pan Arab Endodontic Conference. He has numerous publications in peer-reviewed journals and is a member of the Scientific Advisory Board of the Journal of Endodontics. He is also a reviewer for multiple other Endodontic journals, such as International Endodontic Journal, Journal of Dental Traumatology and Journal of the American Dental Association (JADA).

Citations:

  • American Association of Endodontists. (2018). Root Canal Awareness Week Celebrates The Superheroes Of Saving Teeth | American Association of Endodontists. [online] Available at: https://www.aae.org/specialty/2018/05/09/root-canal-awareness-week-celebrates-the-superheroes-of-saving-teeth.
  • Radiologyinfo.org. Dental Cone Beam CT. [online] Available at: https://www.radiologyinfo.org/en/info.cfm?pg=dentalconect. Salehrabi R, and Rotstein I. (2004). “Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study.” Journal of Endodontics. Volume 30, Issue 2, 846–850.
  • Setzer, Frank C. et al. “A Survey of Cone-beam Computed Tomographic Use among Endodontic Practitioners in the United States,” Journal of Endodontics, Volume 43, Issue 5, 699–70.
  • Yee, Kandace et al. “Survival Rates of Teeth with Primary Endodontic Treatment after Core/Post and Crown Placement,” Journal of Endodontics, Volume 44, Issue 2, 220–225